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Vasovagal syncope of the untoward kind

Posted Dec 11 2009 3:00pm

One of the most embarrassing things to ever happen to me occurred when I was about 16 (surprise, surprise!) Although I didn’t have SIBO way back then I did have some intermittent IBS that came and went until years later when I started eating vegan. It was a party of some sort at my boyfriend’s house and I had eaten a lot of junk food and I started having stomach cramps. I went to the bathroom and that’s where the trouble really started. In addition to spasmy, crampy pain, I started to feel like I was going to throw up. I sat there on the toilet, having terrible diarrhea and getting more and more nauseous. I got hotter and sweatier and I started feeling like someone had dropped me into the bottom of a giant metal cup; all my hearing got tinny and thin. The next thing I know I was on the floor, and my boyfriend’s mom, head of Cardiology at a local hospital, was kneeling overtop of me. I had lost consciousness while on the toilet! She checked me out and I was fine. Cramps and nausea and everything else were gone. I cleaned myself up and that’s all I remember – I most likely lay down and went to sleep if I didn’t run back home out of embarrassment!

My sister took me to the doctor a few weeks later. (This would seem to be pretty par for the course for most folks, but actually going to the doctor when something weird happened to me would not be a theme in my life for the next decade or so.) He asked a few questions about what happened and although my boyfriend’s mom didn’t accompany us, she told us what to say. He did a few routine checks, found I had low blood pressure, and therefore pronounced me subject to vasovagal episodes, and bid us good day.

And it has happened to me ever since. Not a lot, but a couple of times a year most every year. And these past few years it has happened a few more times than that. In my life I’ve woken up on the bathroom floor more times than I’d like to remember (I used to think I had just lain down;) most usually on the bathmat, occasionally in the bathtub (with a bruised head to follow,) and once with my husband kneeling over me the same way my high school boyfriend’s mom did. “Oh I never told you I passed out?” I asked sheepishly…

To date in 2009 I’ve had 3 vasovagal episodes; 2 of them have occurred this week. Back in March I had the pleasure of passing out in front of a doctor; this meant I woke up to pure oxygen, which was quite pleasant! Both times this week when they occurred I managed to avoid full-blown syncope; the first episode was rather mild, but the second time was a bit traumatic. By now I’ve learned to just lie down on the floor when I feel it coming. But I was in the ladies’ room at work so I had to stay put on the toilet. And the prodome to losing consciousness just wouldn’t end. The nausea was terrible and I nearly completely lost my hearing. And something happened which I’ve never noticed before – I shook for about 15 seconds at one point, nearly falling off the toilet. I was worried that I was having a seizure but I was still awake. I asked my husband about the convulsing later, since he was actually present during the episode in the spring, and he said that I shook a bit before I collapsed then too.

I think the worst thing ever about my vasovagal episodes, besides the nausea, because I really can’t stand that part, is that they happen on the toilet. I don’t know what a blog about bowel disease would be without lots and lots of frank discussion of bowels. And years of blog posts, forum posts and doctor’s visits have definitely desensitized me to the topic. But before the SIBO, I wasn’t known as someone with a particular penchant for potty humor or conversation. I don’t really like to talk about going to the bathroom, I definitely don’t like to tell funny stories about the bathroom, and I have even shunned a good morning or goodbye kiss or two when just standing in the bathroom as I much prefer the sterility of the hallway. Yet here is where I like to pass out. Not fair.

It gets better. If you follow the link to the wiki entry on vasovagal episodes, you’ll see that what I have is actually even named after going to the bathroom – defecation syncope. That’s right. So, years of feeling awkward as a teenager/early twenty-something don’t get made up for here. Because I faint – how feminine of me, but I faint on the toilet. Awkward indeed! This is no gender-role-validating, subservient Victorian frail act, oh no, but rather something vile that I do behind a closed door. Turns out I would have to wait for several more years to come down with a condition with the word ‘intestinal’ in it before I would be made to feel girly by my own malaises*.

Of course, like many conditions from which I suffer, lots of ideas (but not all) about vasovagal syncopes center around the psychological aspect, and assume that triggers are triggering for emotional reasons, not necessarily physical ones, or at least that there is some emotion mixed in there somewhere. I do also pass out when I see my own blood. This keeps me from giving blood and when I get tattooed or have blood drawn for labs its essential that I don’t look at what’s happening to me. But just like defecation, I don’t have any particular emotional reaction to blood. This is probably hard for some people to understand, especially as they watch me go under, but I’m not squeamish. In fact, I used to be a big fan of gory movies. I don’t fear needles or bleeding. I don’t mind blood at all. Just like I don’t particularly like or dislike going to the bathroom anymore or any less than anyone else. But I cannot give blood or plasma and when I get a tattoo I have to make decisions about colors before we begin, and I have to trust the artist implicitly.

Here’s hoping to a relatively calm rest of the year…I’d like to end on no more than three!



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